Construction and validation of frailty risk prediction model in patients with acute stroke
10.3969/j.issn.1671-8348.2024.20.011
- VernacularTitle:急性脑卒中患者衰弱风险预测模型的构建及验证
- Author:
Shouqi WANG
1
;
Hong JIANG
;
Jiao XU
;
Ying WU
Author Information
1. 苏州大学附属第二医院神经内科,江苏苏州 215004
- Keywords:
stroke;
frailty;
risk prediction model;
nomogram
- From:
Chongqing Medicine
2024;53(20):3100-3107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of frailty in the patients with acute stroke,and to construct and verify its nomogram prediction model.Methods The simple random sampling method was a-dopted to select the inpatients with acute stroke admitted to a class 3A hospital of Suzhou City from Septem-ber 2022 to May 2023 as the study subjects.The general information questionnaires,Chinese version of Til-burg Frailty Scale(TFI),Health Questionnaire Depressive Symptom Group Scale(PHQ-9),Barthel Index(BI),Morse Fall Assessment Scale(MFS),Braden Pressure Ulcer Risk Assessment Scale and Kubota drink-ing water test were used to conduct the survey.The univariate and multivariate logistic regression were adopt-ed to analyze the influencing factors for frailty occurrence in the patients with acute stroke The nomogram prediction model was constructed.The Bootstrap method was adopted to conduct the internal verification of prediction model.The goodness of fit was evaluated by the Hosmer-Lemeshow test.The discrimination was e-valuated by the C-index.The consistency was verified by the calibration curve.Results A total of 193 patients with stroke were included,among them 70 cases developed frail with an incidence rate of 36.3％.The univari-ate analysis results showed that BMI,NIHSS score,PHQ-9 score,BI score,Braden score,age,history of diabe-tes,fall risk,modified Rankin scale(mRS)score ≥2 points and dysphagia were related with the frailty occur-rence in the patients with acute stroke(P＜0.05).The variables of the prediction model included the age,his-tory of diabetes,PHQ-9 score and Braden score.The area under the receiver operating characteristic(ROC)curve was 0.839(95％CI:0.781-0.897),the best cutoff value was 0.328,the sensitivity was 78.6％and the specificity was 75.6％.The Hosmer-Lemeshow test showed the goodness of fit was good(x2=12.281,P=0.139).C-index was 0.839(95％CI:0.781-0.897),the prediction mode had good discrimination.The cali-bration cure showed that the frailty occurrence risk predicted by the model had good consistency with the ac-tual risk occurrence.Conclusion The constructed nomogram model could predict the occurrence risk of frailty in the patients with acute stroke,which provides a basis for the nursing staff condcuting early screening and intervention.
